...Community Health Nursing SZT Task 2 February 7, 2014 A. Personal Perceptions Serving as a patient care advocate is the most important role a nurse serves as a health care provider. Nurses serve to support the patient, sometimes having to put their own personal beliefs and values to the side. Although this is ingrained in us as nurses, sometimes health care providers allow their emotions to alter their perspective when dealing with death and dying. For twenty-four years I have served as a critical care nurse, and as an ICU nurse, I have been trained to help patients and families through this time of illness to provide care to help them heal and get better. Despite all that we do to treat patients, sometimes their illnesses are such that they do not get better and a decision is made to pursue comfort care. Since we are trained to help patients and families heal, this can be difficult to handle. Regardless of my personal feelings or beliefs, I always encourage my patients and their families to make the decisions that are best for them with the information they have been given. Our job as patient care advocates is crucial, especially when dealing with end of life and quality of life issues. The National Institute of Health defines hospice as “end of life care provided by health professionals and volunteers.” This type of care gives attention to pain control while trying to keep the patient as alert as possible. A referral to hospice is placed when a patient...
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...STUDY GUIDE for C475 Care of Older Adult Objective Assessment Exam questions are taken from the Learning Objectives under the 9 Competencies: #1 Competency 742.1.1: Compassionate and Respectful Care of Older Adults The graduate integrates principles of compassion and respect for patients and their families into the planning and delivery of care to a diverse population of older adults and into advocacy for vulnerable older adults. This topic addresses the following learning objectives: * Recognize the impact of attitudes, values, and expectations about aging. * Describe how the RN’s personal beliefs and values may impact the care of older adults. * Articulate the concept of individualized care as the standard of practice with older adults, considering the right care, at the right time, in the right place and by the right provider of care. * Define Baby Boomers * What are the five racial groups listed in your text? * How would you perform discharge teaching to an Hispanic patient * Apply effective and respectful communication strategies in the care of older adults and their families. * List some of the changes of aging that could affect therapeutic communication * Note the ways to communicate or assist a patient with disabilities such as hearing deficits, vision impairments, or aphasia and dysarthria. Be familiar with the types of hearing devices. How should you address the older adult during therapeutic communication? ...
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...STUDY GUIDE for C475 Care of Older Adult Objective Assessment Exam questions are taken from the Learning Objectives under the 9 Competencies: #1 Competency 742.1.1: Compassionate and Respectful Care of Older Adults The graduate integrates principles of compassion and respect for patients and their families into the planning and delivery of care to a diverse population of older adults and into advocacy for vulnerable older adults. This topic addresses the following learning objectives: * Recognize the impact of attitudes, values, and expectations about aging. * Describe how the RN’s personal beliefs and values may impact the care of older adults. * Articulate the concept of individualized care as the standard of practice with older adults, considering the right care, at the right time, in the right place and by the right provider of care. * Define Baby Boomers (those born from 1946–1964) reach retirement age (as of 2011) A large group of people born between 1946 and 1964, in the time after the Second World War. * What are the five racial groups listed in your text? African American, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander/Asian, Hispanic, White * How would you perform discharge teaching to an Hispanic patient Teach the family as well because more than likely, pt is going home and family is his/her primary caregivers. * Apply effective and respectful communication strategies in the care of older adults and their...
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...Strengths and Weaknesses……………………………………………………………….11 Timeline and Cost Considerations……………………………………………………….12 Conclusion……………………………………………………………………………….13 Concept Model………………………………………………………………..Appendix A Sample Questions……………………………………………………………..Appendix B References……………………………………………………………………………….18 Research Proposal Research Proposal Introduction Intensive care units (ICUs) were designed to provide highly skilled, lifesaving nursing care to viable patients with acute illnesses or injuries. Patients with chronic and/or terminal illness were not expected to be admitted to these units, with the possible exception of acute exacerbations of reversible complications. Patients whose care needs changed from curative to palliative were intended to be transferred out of critical care to patient care environments more suited to end-of-life care. However, as more patients become “chronically critically ill”, critical care nurses are being asked more often to provide care to patients on their deathbeds (Puntillo et al., 2001). Deciding which ICU patients are actually dying remains an extremely inexact science, and the transition to palliative care is not one easily made. ICU mortality rates are as high as 69% (Puntillo et al., 2001);...
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...Interview of a Hospice Chaplin The Duties of a Hospice Chaplin Michell McGill June 25, 2012 BSHS/302 Tami Frye Hospice Care and Hospice Counseling is a growing profession, which is being incorporated in many hospital and doctor’s offices today. Today there are many private companies who provide these services and they employ Chaplains to assist the patient and the families in making many decisions in reference to end of life wishes. There are many misconceptions as to the purpose of Hospices and the services they provide. The Hospice Chaplin can supply services such as emotional comfort, assist with reconciliation, assist with funeral/ memorial service and any other concerns the patients may have. My own misconception was a reason that I felt the need to research and find out more information. There are many ways to interview an agency, telephone calls, personal interview, and email or an investigative interview as a potential client. I choose an email interview because of the work schedule of the Chaplin and our inability to find a convient time for each of us to meet. . Interview of a Human Service Provider Person Interview (and organization) Kimberly Young-Hardin, MDiv, SCC – Providence Hospice Date of Interview Saturday June 25, 2012 Person Conducting the Interview Michell Walter McGill Hello, my name is Michell W...
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...Three major categories of institutional medical care * Hospital are devoted mainly to acute intensive care of a limited duration. * Nursing homes provide long-term residential care for people who are chronically ill and those whose illness does not require acute, intensive care. * Hospice care is distinguished by its orientation toward the needs of dying patients and their families Rationing-refers to the allocation of scarce resources among competing individuals. In health care it is defined as any system that limits the amount of health care a person can receive. Paternalism- the assumption of parent like authority by medical practitioners, is seen as infringing on a patient’s autonomy or freedom to make medical decisions. Covenantal relationship- which implies a mutuality of interest between provider and patients. Eight principles that are important when delivering bad news 1. Keep it simple 2. Ask yourself, “What does this diagnosis mean to the patient?” 3. Meet on “cool ground” first. Get to know a patient prior to presenting the news. 4. Wait for questions. 5. Do not argue with denial. 6. Ask questions yourself. 7. Do not destroy all hope. 8. Do not say anything that is untrue. Strategies that either curtail or encourage conversation when speaking of death by a caregiver * Reassurance * Denial * Changing the subject * Fatalism * Discussion “Whole person care”- caring for seriously ill and dying patients...
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...Hospice Care Hannae Warren HCS/212 Kristie Racca October 24, 2011 Hospice is a term that is traced back to medieval times; it was a place where tired or sick travelers could find a place of shelter, rest, and care (“History of Hospice Care,” 2010). Since the medieval times hospice care has evolved into a contemporary program that offers patients facing terminal illnesses medical, spiritual, and psychological care. A physician named Dame Cicely Saunders first proposed the thought of specialized care for the terminally ill in 1963, and in 1967 she founded the first modern hospice in a residential suburb of London (“History of Hospice Care,” 2010). This was the beginning of modern day hospice care which provides patients the humane and compassionate care that is beneficial to people that are in their last phases of incurable diseases, so that they may live as much as possible and as comfortably before they pass away (“Hospice Care,” 2011). The Hospice viewpoint is that death is the final stage of life, they support life, and neither rush nor delay death (“Hospice Care, 2011). The ultimate goal of any hospice is to assist patients live their last days on earth as a alert and as pain-free as possible (“Hospice Care,” 2011). Hospice care is helpful when...
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...Creation of Hospice Hospice care is designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life rather than cure. The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. The term “hospice” ( from the same linguistic root as “hospitality”) can be traced back to medieval times when it referred to a place of shelter and rest for the weary or terminally ill on a long journey in 1948 (History of Hospice Care, 2012). The name of the physician was Dame Cicely Saunders who treated the terminally ill and eventually went on to create the first modern hospice, named St Christopher’s Hospice, in a residential suburb of London. (History of Hospice Care, 2012). Ms. Saunders introduced the idea of specialized care for the dying to the United States of America during a 1963 visit with Yale University. Her lecture, given to medical students, nurses, social workers, and chaplains, about the concept of holistic hospital care, included photos of terminally ill patients and their families, showing the dramatic differences before and after the symptom control care (History of Hospice Care, 2012). Ownership In 2010, there were over 5000 hospice programs nationwide (Facts and Figures: Hospice Care in America, 2012). The majority of these facilities are freestanding agencies constituting 58 percent of all hospice centers (Facts and Figures: Hospice Care in America, 2012). They are...
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...Patients' and End of Life Care: A Multidisciplinary Concept Analysis Jennifer Thompson UTA Analysis of Theories in Nursing Nurs 5327 Ronda Mintz-Binder, RN, MSN, DNP April 19, 2014 Terminally Ill Patients' and End of Life Care: A Multidisciplinary Concept Analysis With an aging population in our country we are facing an increasing number of patients’ that are coming to the end of their lives and are presenting with terminal illness. As life expectancy increases we are seeing more and more patent that are 65 year old and older in need of end of life care. Research and medical developments have provided a vast array of treatment options available to our patients’. After patients’ have exhausted all available treatment options for their disease processes they face the reality that their life is coming to an end. Patients’ near the end choose between quality of life over quantity of life. One service available to terminal patients’ is hospice care which offers palliative care to patients’ at the end of life. Health care providers must be able to face and appropriately care for patients’ with terminal illness and end of life care. At times it may be difficult for health care providers to face or present the truth to a patient that further treatment is futile and end of life care would be appropriate. Advanced practice nurses’ will face terminal illness and it is required of them to be able to sufficiently treat, manage, and discuss end of life care with these patients. It is...
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...Enhancing end-of-life care (EoLC) is a core component of international governments’ health policies. Across the globe, nurses make significant contributions to EoLC and, at this delicate time, have the power to positively influence the health and wellbeing of those facing death. Indeed, health promotion is a core component of the nurse’s role. Originating in the UK, EoLC pathways have been adopted around the world.Their broad aim is to optimise the quality of the dying process, enabling people to ‘die well’ across care settings. This paper examines EoLC pathways in terms of promoting health and wellbeing in this discrete stage of the dying trajectory. Concepts of health and health promotion are described briefly and the idea of health-promoting palliative care and its association with a good death examined. The ensuing discussion relates to two EoLC documents. While acknowledging that much has been achieved it is argued that, despite the potential for promoting health and wellbeing, a professionally led, biomedical approach predominates, and in terms of promoting health and wellbeing at the end of life there is a pressing need for proactive advance care planning at an earlier point in the illness trajectory. Key words: End-of-life care l Care pathways l Terminal care l Health promotion Michael Allen is Staff Nurse, Chemotherapy Day Unit, Singleton Hospital, Abertawe Bro- Morgannwg University Hospital Board, Swansea, Wales; Tessa Watts is Senior Lecturer, Swansea University,...
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...When you think of hospice, you think of palliative care typically seen utilized by the elderly population. Hospice provides comfort care for those individuals passing from life onto death. In addition, hospice gives support, provides education, and facilitates closure for loved ones during this transition. Hospice plays vital role in our healthcare system and is necessary in end of life care. According to the article, 44,000 pediatric deaths occur each year but only 10% of pediatric population utilizes hospice care. Clearly, hospice is a vital service that is being underused in the pediatric population. This article examines the characteristics of children who utilize hospice care so that we can better understand spread understanding for hospice...
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...Hospice Care in the United States Catherine Harmer HCS.212 Feb.23, 2013 Prof. Mark Miller Hospice Care in the United States Hospice care is one of the best services the health care industry has to offer, and is available to all walks of life. When the patient has reached end of life, hospice provides support to the loved ones as well. “Hospice focuses on caring, not curing and, in most cases; care is provided in the patient’s home. Hospice care also is provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities. Hospice services are available to patients of any age, religion, race, or illness. Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations” (NHPCO, 2011, par.2). Hospice care has evolved over many years and has a lot to offer: Patients are kept as comfortable as humanly possible. For loved ones, finding peace or comfort is likely more achievable when helping their loved ones let go, making the course of grieving and acceptance much less difficult. Caregivers, employees, and volunteers are faced day-to-day with the reality that life as we know it does expire; it is only fitting then, that greater patience and appreciation of self, family, and life in general become more characteristic of the providers than might be otherwise. This facet of health care, one might fear, would require tremendous resilience. On the other hand however, facilitating a...
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...by providing assisted care if they were wounded or ill. One person was given the title role to become the administer of medicine or the healer of all sick through spirituality (Amitabha Hospice Service Offering Kindness & Clarity, 2000). Death rates for mother and children's were tremendously high, fewer people lived over the age of 40, and most of every resource was devoted to survival. Christianity began to spread in Europe and churches or monasteries which lead to the intake of sick and the disabled. Women who were well off or lost their husbands volunteered to work in the monasteries as care takers. During Medieval times during crusades, travelers discovered places of refuge with the nunneries as well as the monasteries. During the development of medicine and hospitals, the ill patients found treatment at these facilities but as diseases formed and the fear of outbreaks developed family members preferred for the care to take place in the home. The community would then prepare food and provide clothing for the individuals families who were taking care of them. The aftermath of WWII helped healthcare services provide better medicine for the ill which saved a lot of lives. The name hospice originated from the care of the terminally ill patients by Mme Jeanne Garnier and founded The Dames de Calaire in Lyon, France during 1842. Hospice care is an important part of health care usually according to (NHPCO - National Hospice and Palliative Care Organization, 05/1)...
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...(DNP) Projects Theses and Dissertations 1-1-2009 The Experience of African American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care Elizabeth Joy Gifford University of San Francisco, lgiffman1@aol.com Follow this and additional works at: http://repository.usfca.edu/dnp Part of the Nursing Commons Recommended Citation Gifford, Elizabeth Joy, "The Experience of African American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care" (2009). Doctor of Nursing Practice (DNP) Projects. Paper 14. This Project is brought to you for free and open access by the Theses and Dissertations at USF Scholarship Repository. It has been accepted for inclusion in Doctor of Nursing Practice (DNP) Projects by an authorized administrator of USF Scholarship Repository. For more information, please contact zjlu@usfca.edu. COMPREHENSIVE EXAM 2 Section I: Introduction Statement of the Problem Although 60% of African Americans in the United States have stated that they would want hospice care when they are dying (AARP, 2003), they only comprise 8% of all hospice enrollees (NHPCO, 2007), despite the fact that they represent 13% of the total population in this country (U.S. Census Bureau, 2008). In fact, hospice care in this nation has always been underutilized by African Americans (Connor, Elwert, Spence, & Christakis, 2008). In the San Francisco Bay Area, among Medicare-certified hospice agencies...
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...consequences of the act we wish to evaluate or the rule that guides the action, we look at the character of the person performing the act."(Mosser, 2010) Each having the same outcome but still different, physician assisted suicide is when a physician gives the patient means to commit suicide but not administering it personally.Euthanasia is a lethal dosage of medicine administered by a physician. (Gula,1999a) This process is called death by mercy but some see it as murder. Death is a natural part of living. Death is something that occurs somewhere every second of the day, it should be from natural cause or accidental never should it be doctor promoted . When people become ill it is the physician they put trust in for the care they need to survive the illness they have become stricken with. This is not always the case, depending on the severity of the illness some have ask physicians to assist in their death. The physician must be responsible and alert the patient of their choices when a life threatening illness occurs. Physician assisted suicide demonstrates ethical egoism, even though it satisfies ones desire it is not always the...
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